Slow walking speed in elderly people and increased risk of cardiovascular death


Slow walking speed in elderly people and increased risk of cardiovascular death

New research published today on bmj.com reports that older people who walk slowly are three times more likely to die from cardiovascular disease than those who walk faster.

The authors say these findings underline the essential role of fitness in preserving life and function in older age.

Earlier studies have revealed that low walking speed can predict adverse health related events, including death. However, it is unclear whether particular causes of death account for this increased mortality.

In order to find out more, a team of researchers from France investigated the relationship between low walking speed and the risk of death in older people. They considered both variables in general and with regard to the major underlying causes of death which were defined as cancer, cardiovascular, and other causes such as infectious diseases or respiratory failure.

The findings of the study are based on the five year monitoring of 3,208 men and women living in the community. They were aged 65 to 85 years and took part in the Three City Study in France.

Demographic and medical information was obtained at the start of the study. Participants were asked to perform a walking test over six meters. A speed camera was used to capture an automated measure of walking speed.

Monitoring examinations were performed over five years at regular intervals. Risk of death was calculated according to thirds of walking speed - lowest, middle, and highest.

After rectifying several baseline characteristics, individuals in the lowest third of walking speed at the start of the study had a 44 percent increased risk of death compared to those in the upper thirds.

In the same way, participants in the lowest third of walking speed had a three times increased risk of cardiovascular death than those who walked faster. This augmented risk of cardiovascular death was observed in both men and women. It was also apparent in younger as well as in older individuals and in participants with low or usual physical activity.

Interestingly, no relationship between walking speed and death from cancer was found.

The authors write in conclusion: "These findings show that assessment of motor performances in older people using simple measures such as walking speed can be performed easily and that the role of fitness in preserving life and function in older age is important."

An associated editorial supports these findings and suggests that walking speed may also assist in predicting future ill-health in older people.

"Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study"

Julien Dumurgier, neurologist, Alexis Elbaz, epidemiologist, Pierre Ducimetiere, senior epidemiologist,Béatrice Tavernier, geriatrician, Annick Alpérovitch, senior epidemiologist, Christophe Tzourio, head of the Inserm neuroepidemiology unit

BMJ 2009; 339:b4460

doi:10.1136/bmj.b4460

"Slow walking speed in elderly people"

Rowan H Harwood, consultant geriatrician, Simon P Conroy, geriatrician

BMJ 2009; 339:b4236

bmj.com

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Section Issues On Medicine: Cardiology